MEDICARE: PAUL OLSON COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1326762535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL OLSON COUNSELING LLC

Provider Business Mailing Address
First Line	:	308 CLEVELAND AVE STE 302
Second Line	:
City	:	ISHPEMING
State	:	MI
Zip	:	49849-1842
Country	:	US
Telephone Number	:	906-290-7492
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 CLEVELAND AVE STE 302
Second Line	:
City	:	ISHPEMING
State	:	MI
Zip	:	49849-1842
Country	:	US
Telephone Number	:	906-362-1491
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL THEODORE OLSON
Credential	:	LMSW
Telephone Number	:	906-362-1491

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	02/13/2023

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